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BMJ. 1990 September 1; 301(6749): 412–415.
PMCID: PMC1663706

Impact of HIV on tuberculosis in Zambia: a cross sectional study.


OBJECTIVE--To examine the contribution of HIV infection to the apparently increasing incidence of tuberculosis in central Africa. DESIGN--Cross sectional study. SETTING--Outpatient clinic in teaching hospital, Lusaka, Zambia. PATIENTS--346 Adult patients with tuberculosis. RESULTS--Overall, 206 patients (60%; 95% confidence interval 54% to 65%) were positive for HIV--in one or both assays used. The peaks for both tuberculosis and HIV infection were among men aged 25-34 years and women aged 14-24 years. Of patients with confirmed pulmonary tuberculosis, 73/149 (49%; 41% to 57%) were positive for HIV; 67/83 (81%; 70% to 89%) patients with pleural disease and 16/19 (84%; 60% to 97%) patients with pericardial disease were positive. HIV positive patients with positive sputum culture were less likely to have had a positive sputum smear, and their chest x ray films less often showed classic upper zone disease or cavitation. Of 72 patients who fulfilled clinical criteria for AIDS, 17 were negative for HIV. CONCLUSIONS--The high prevalence of HIV in patients with tuberculosis suggests that an epidemic of reactivating tuberculosis is arising in those who are infected with HIV. The redirection of public health priorities towards tuberculosis would focus on a major treatable and preventable complication of the AIDS epidemic.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Slutkin G, Leowski J, Mann J. The effects of the AIDS epidemic on the tuberculosis problem and tuberculosis programmes. Bull Int Union Tuberc Lung Dis. 1988 Jun;63(2):21–24. [PubMed]
  • Colebunders RL, Ryder RW, Nzilambi N, Dikilu K, Willame JC, Kaboto M, Bagala N, Jeugmans J, Muepu K, Francis HL, et al. HIV infection in patients with tuberculosis in Kinshasa, Zaire. Am Rev Respir Dis. 1989 May;139(5):1082–1085. [PubMed]
  • Blaser MJ, Cohn DL. Opportunistic infections in patients with AIDS: clues to the epidemiology of AIDS and the relative virulence of pathogens. Rev Infect Dis. 1986 Jan-Feb;8(1):21–30. [PubMed]
  • Chaisson RE, Schecter GF, Theuer CP, Rutherford GW, Echenberg DF, Hopewell PC. Tuberculosis in patients with the acquired immunodeficiency syndrome. Clinical features, response to therapy, and survival. Am Rev Respir Dis. 1987 Sep;136(3):570–574. [PubMed]
  • Pitchenik AE, Rubinson HA. The radiographic appearance of tuberculosis in patients with the acquired immune deficiency syndrome (AIDS) and pre-AIDS. Am Rev Respir Dis. 1985 Mar;131(3):393–396. [PubMed]
  • Pinching AJ. Prophylactic and maintenance therapy for opportunist infections in AIDS. AIDS. 1988 Oct;2(5):335–343. [PubMed]
  • Soriano E, Mallolas J, Gatell JM, Latorre X, Miró JM, Pecchiar M, Mensa J, Trilla A, Moreno A. Characteristics of tuberculosis in HIV-infected patients: a case-control study. AIDS. 1988 Dec;2(6):429–432. [PubMed]
  • Sunderam G, Mangura BT, Lombardo JM, Reichman LB. Failure of "optimal" four-drug short-course tuberculosis chemotherapy in a compliant patient with human immunodeficiency virus. Am Rev Respir Dis. 1987 Dec;136(6):1475–1478. [PubMed]

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